Provider Demographics
NPI:1730270547
Name:MILLER, ESTHER LEE (LCSWR)
Entity type:Individual
Prefix:MS
First Name:ESTHER
Middle Name:LEE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 PIONEER ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326
Mailing Address - Country:US
Mailing Address - Phone:607-547-1303
Mailing Address - Fax:607-547-2881
Practice Address - Street 1:45 PIONEER ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326
Practice Address - Country:US
Practice Address - Phone:607-547-1303
Practice Address - Fax:607-547-2881
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0550701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB7159Medicare ID - Type Unspecified